The parties may agree to a different performance. This is called an accord. When the accord is performed, this is called an accord and satisfaction. The original obligation is discharged. In order for there to be an accord and satisfaction, there must be a bona fide dispute; an agreement to settle the dispute; and the performance of the agreement. An example would be settlement of a lawsuit for breach of contract. The parties might settle for less than the amount called for under the contract.
Anthem Claim Dispute Form With Decimals In Middlesex
State:
Multi-State
County:
Middlesex
Control #:
US-00435BG
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
After you fill out the form, Mail/Fax/deliver your request for a hearing within 33 days of the date of the notice you are appealing. Mail: FSSA Document Center PO Box 1810 Marion, Indiana 46952 Fax: 1-800-403-0864 Visit your local DFR/Medicaid Office.
One redetermination form can be submitted for multiple claims only for denials by the Unified Program Integrity Contractor or Medical Review probe reviews. Fax request to 1-888-541-3829.
Yes. We will retain the Blue Cross and Blue Shield and Blue Cross in our name. Anthem Blue Cross and Blue Shield and Anthem Blue Cross are our local health insurance companies in our 14 Blue-licensed markets and will continue to be our local health plan brands in those states, which now includes New York.
You can also fax to 855-516-1083. Please be sure to mark "EXPEDITED" on the form before faxing.
Customer Care Centers Call 888-831-2246 Option 4 and ask to speak with Dr.
File the appeal within ten (10) days from the date your "Determination of Eligibility" was sent by one of these methods: Mail the appeal to 10 North Senate Avenue, Indianapolis, IN 46204; Fax the appeal to (317) 233-6888; Deliver the appeal in person to the Department at 10 N.
Please fax to 1-855-516-1083. You may ask us to rush your appeal if your health needs it. We'll let you know we got your appeal within 24 hours from the time we received it.
Anthem Blue Cross is the trade name of In California: Blue Cross of California, Anthem Blue Cross Partnership Plan, Anthem BC Health Insurance Company and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.
Effective Date: January 1, 2024 Plan NameSingle (1)Two-Party (2) Anthem Blue Cross Del Norte EPO $1,240.19 $2,480.37 Anthem Blue Cross Select HMO $944.08 $1,888.16 Anthem Blue Cross Traditional HMO $1,221.90 $2,443.80 Blue Shield Access+ EPO $910.34 $1,820.6815 more rows •
